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ADHASA - Link to the South African Support group & website

Teaching a child with ADHD how to follow instructions 

ADD  = Attention Deficit Disorder and ADHD = Attention Deficit & Hyperactivity Disorder. ADD or ADHD is not something that is easy to diagnose as it may often be the symptom of other difficulties. These terms are an umbrella term for difficulties children (& adults) have with staying focused and with concentration difficulties.

ADHD kids may have or have had some of the following difficulties:

Gross motor or fine motor difficulties,
Speech & hearing problems,
Tactile defensiveness,
Sensory processing difficulties,
Sleeping or eating problems,
Social and emotion difficulties,
Arousal problems or activity levels that dysfunction,
Concentration difficulties,
Hyperactive 

Generally ADD/ADHD children have a combination of a few or most of the above.

When you learn your child has ADD or ADHD it can be devastating, or it can be a relief. At least when you have a diagnosis you realise that your child's so called "bad behaviour" is not your fault.  Once a diagnosis has been made you can deal with it. Other people will be able to understand and deal with the difficulties too.

Parenting is never easy and we are generally unprepared for parenting. An ADD child will challenge everything you think that you know about parenting. Most people bring into the marriage the experiences they have gained from watching other parents. This is not always helpful and certainly not enough to help us with an ADD child. ADD kids can be absolutely impossible and unpredictable at times and so parenting is even more of a challenge then usual. Often ADD kids do not keep up with their peers emotionally and socially which adds to the problem. Most ADD kids are very inquisitive and impulsive, and when given instructions they simply don’t listen and sometimes they do really dangerous things, like running across roads without looking. They may refuse to hold an adults hand when crossing a road. If you insist that they hold your hand they may squirm and scream and throw themselves on the floor. It makes no difference if you explain the dangers, they just continue to do whatever it is they were intent on doing. It is extremely frustrating. If you visit a your doctor or pediatrician they may suggest a hearing test for the child. Probably you will find the child’s hearing is absolutely fine. But I do receommend that the child has a complete check up so that you can rule out an other health problems. I would recommend an EEG and if indicated an MRI.  

You will notice many differences between ADD children and their siblings. Children without ADD often get on with things on their own and learn to be more independent, they "get things" that the ADD child just doesn’t! ADD children may often battle with social situations, which can become a problem when they go to school. When you realize that you are dealing with a child who may be having difficulties it is a good idea to read everything you can about parenting and also about ADHD. It is also important that you and your partner do this together and discuss the books you have read. It is going to confuse your child if one parent sticks to a traditional parenting method while the other tries out something different. Having an ADD child puts a lot of strain on a marriage. There may be a lot of blame and guilt associated with some of the difficulties one experiences with ADD kids. If you are constantly arguing about parenting techniques, and fighting over discipline issues it is not going to be easy. Some parents may still believe in the good old fashioned "hiding" or smack for a naughty child. An ADHD child is not naughty. This type of autocratic parenting will not work with a ADHD child. It is also illegal to smack children.

I have talked to talk to many specialists, principals of special schools, therapists and other parents over the years. The best advice I have been given is that one needs to train ADD children to listen and to respond to what you are saying. Many of the behavior problems associated with ADD & ADHD are due to the fact that the children do not attend to what is happening around them and to what they are instructed to do.

Start off by giving your child proper instructions. Listen to what you are telling him to do. For example: What does "Go and get ready for school" or "Behave nicely" really mean to a child? If you want him to behave properly then you need to describe the exact behavior you don’t want and the behaviour you do want. Rather then saying "behave properly" say to the child "stop jumping on the furniture". or "play quietly together".  Children with ADHD are distracted and inattentive so they may only hear the first few words of your instruction. When you give your ADHD child an instruction you need to start off by giving him or her one instruction at a time. Make the instruction short. If you say "Mommy really wants you to be a good boy and run along and put on your shoes." He will have stopped listening after " Mommy wants….." You need only say "Put on your shoes". Even a sentence such as "Go to the bathroom and brush your teeth" is not a simple instruction. It’s 3 or 4 instructions, ie go to the bathroom, find your toothbrush, put on the toothpaste, brush your teeth, rinse your mouth, dry your mouth….

When you give your child an instruction you need to make sure he is listening to you and that he understands you. You cannot give an ADHD kid an instruction from across the room when he is not looking at you. You need to call the child over, or go over to him. If you call him and he doesn't look at you, go over to him. Face him, look at him and make sure he is looking at you. If necessary hold his hands in front of you or hold his face and speak to him. Give him the instruction eg "Put on your shoes", and then ask him to repeat the instruction so that you know he has heard you and understood it.  Once your child repeats the instruction watch that he does what you asked. You may even have to hold his hand and take him step by step through what you want him to do. When he done what you asked him to, praise him! Do not scream at him, or shout, or lose your temper when he doesn’t do what you have asked because this does not help. Sometimes you may want to tear your hair out, but it is important that you remove yourself from the situation if you feel like this. Pretend he is an alien from another planet that needs to be instructed on the laws on this planet, and show him how to do everything. Sometimes having an ADHD kid is like having an alien from another planet. But he is an alien who loves you and really needs you to be patient and kind and not someone who hits him and shouts at him, even though you may feel like doing it.

When your child can consistently follow one simple instruction increase it tthe instructions to two. In some cases this could be something like "Put on your shoes" and then "tie the laces"… If your child is older he may have been getting away with doing exactly what he wants and then you will have to show him you are not going anywhere until he has done what you have asked. When he has to do a task watch over him and make sure he has done it. If you ask an older child to tidy his room do it with him the first time and show him exactly what you expect. Explain what a tidy room means to you. I am sure that his standards of tidiness will be altogether different to yours!

In the beginning when it may be difficult and strange to do this. Your child is probably very intelligent and could do many other things, but when you expected him to do something simple like getting ready for school in the morning he simply forgot what is expected. Once Iyou see that this method is starting to work and makes things easier. You will also see that your relationship will improve. This is a better method for both of you, then losing your temper. It will become a pattern of behavior and will improve your life.

There were other things that you can modify for an ADD kid, which will help behavior. Diet, vitamins, omega oils etc. I found that zinc & copper is very beneficial for balancing an ADD child's moods. You can also try to implementing star charts, diarys, lists, posters on the wall with instructions, etc are great for ADD kids. But personally I find none of these were as effective as this simple pattern of talking to your child.

ADHD is a part of your child’s personality and you will have to learn to live with it. But one has always got to bear in mind that you are training your child to be a better adult. ADHD may be an excuse when you are 8, or even 14, but when your child becomes an adult ADD will just a disability that very few people will understand if you haven't helped him to cope in the real world. He needs you to show him how to cope.

 Interesting links for ADD:

ADHASA - South African Support group & website

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